low vision rehabilitation tiffany l chan, od, faao：低视力康复tiffany我陈，od，按照faao

Tiffany L. Chan, O.D., F.A.A.O.Assistant Professor of OphthalmologyLions Vision Rehabilitation CenterThe Wilmer Eye Institute, Johns Hopkins University Understand the utility of Low Vision Rehabilitation Identify Low Vision patients Gain knowledge about educating and counseling patients with vision loss (Patient case example)* Low Vision Research Network (LOVRNET) Study Group Median age - 77 yo Female - 66% Macular disease 55% Trouble reading Difficulty writing Inability to recognize faces Blur watching television Difficulty w/ steps and curbs Glare Problems driving Visual acuity Peripheral visual field Corneal Edema Intraocular pressure Retinal/Macular edema Neovascularization Optic nerve damagePhysician Patient Any chronic uncorrectable visual impairment that limits daily functioning When ordinary eyeglasses, contact lenses or surgery cannot provide sharp vision Leading cause of disability in daily living among Americans The WHO estimates that over 135 million people are visually disabled, and nearly 45 million people are blind Incidence of LV cases from age-related eye disease is expected to double over the next 25 years Can cause major safety concernsIncreased risk of fallsDifficulty with medication managementKitchen accidents Stove/oven turned off Cutting food Seeing when food is properly cooked Nurses Physicians Ophthalmology, PM Speech and Language Pathologists Orientation and Mobility specialist Social workers Teachers for the Visually Impaired To maximize the patients remaining sight to enhance function and independence Visually assistive equipment (VAE) Sensory substitution (i.e. Hearing or touch) No surgical or medical interventions Not “fixing” vision Problems with activities of daily living Difficulty reading and writing Driving concerns / questionable renewals Safety in mobility Evaluating rehab options in high risk eye procedures Post procedure with remaining vision impairment Observations Case History Visual Acuity measure(s) Contrast sensitivity Refraction Visual Field Medical evaluation Assessment/Plan The ability to distinguish an object from its background Patients with poor contrast report difficulties with: navigation (curbs, steps, getting into the tub, etc.) Solutions include: House-hold manipulations Increased lighting Step markings Normal Vision Reduced Contrast Sensitivity VisionMagnification Contrast Enhancement Lighting Control GlareNon-optical aidsRecommend Appropriate Resourc